Abstract
Objective
The first aim of this study was to determine whether the use of computers, internet,
and computer assistive technology (AT) increased social participation after tetraplegia
spinal cord injury (SCI). The second aim was to determine if racial or ethnic disparities
of technology use was experienced.
Design
A secondary analysis of data collected by the National Spinal Cord Injury Models Systems
Study (NSCIMS), an ongoing observational cohort study, was performed on a sample of
3096 participants who experienced a traumatic tetraplegic injury.
Participants
Participants included were at least 1-year post traumatic tetraplegia injury and participated
in NSCIMS between 2011–2016 (N = 3096).
Setting
NSCIMS observational data was originally collected via in-person or phone interviews.
Interventions
Not applicable.
Main Outcome Measure(s)
A binary logistic regression was conducted to determine if self-reported use of computers
or similar device, the internet, computer AT, race, ethnicity, and other demographics
predicted high (≥ 80) versus low/medium (< 80) social participation, measured by the
Craig Handicap and Reporting Technique (CHART) social integration standardized measure.
Results
Combined use of a computer, AT, and the internet predicted higher social integration
by almost 175% (95% CI [2.0, 3.78]; p < .001) compared to no device or internet use.
Racial and ethnic disparities were discovered. Black participants had 28% lower odds
of high social integration than White participant (95% CI [0.56, 0.92]; p < .01).
Hispanic ethnicity predicted 40% lower odds of high social integration compared to
non-Hispanic participants (95% CI [0.39, 0.91]; p = .018).
Conclusion
The internet presents an opportunity to reduce barriers to social participation and
increase overall social integration after tetraplegia. However, race, ethnic, and
income inequities prevent or limit access to the internet, computers, and AT after
tetraplegia for Black and Hispanic people.
Keywords
List of abbreviations:
AIS (American Spinal Injury Association Impairment Scale), AT (Assistive Technology), Craig Handicap and Reporting Technique (CHART), NSCIMS (National Spinal Cord Injury Model Systems), NSCISC (National Spinal Cord Injury Statistical Center), OR (Odds ratio), SCI (Spinal Cord Injury)To read this article in full you will need to make a payment
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Article info
Publication history
Accepted:
January 21,
2023
Received in revised form:
January 13,
2023
Received:
August 1,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
